Relationship between vitamin D status in pregnancy and the risk for preeclampsia: A nested case-control study (original) (raw)
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Vitamin D status in early pregnancy and risk of preeclampsia
American Journal of Obstetrics and Gynecology, 2014
We sought to examine the association between maternal serum 25-hydroxyvitamin D (25[OH]D) concentration in early pregnancy and the subsequent diagnosis of preeclampsia (PE). This was a nested case-control study from 2 prospective Canadian cohorts conducted in Quebec City, Quebec, and Halifax, Nova Scotia, from 2002 through 2010. Participants were pregnant women (n = 169 cases with PE and 1975 controls). Maternal serum was drawn <20 weeks of gestation, and 25(OH)D measurement was performed. Cases were ascertained from medical records. Logistic regression analysis was used to estimate adjusted odds ratios with 95% confidence intervals. Women who developed PE had a significantly lower 25(OH)D concentration at a mean gestational age of 14 weeks compared with women in the control group (mean ± SD 25[OH]D 47.2 ± 17.7 vs 52.3 ± 17.2 nmol/L, P < .0001). Women with 25(OH)D <30 nmol/L compared to those with at least 50 nmol/L had a greater risk of developing PE (adjusted odds ratio, 2.23; 95% confidence interval, 1.29-3.83) after adjustment for prepregnancy body mass index, maternal age, smoking, parity, season and year of blood collection, gestational week at blood collection, and cohort site. Exploratory analysis with cubic splines demonstrated a dose-response relationship between maternal 25(OH)D and risk of PE, up to levels around 50 nmol/L, where the association appeared to plateau. Maternal vitamin D deficiency early in pregnancy defined as 25(OH)D <30 nmol/L may be an independent risk factor for PE. The relevance of vitamin D supplementation for women of childbearing age should be explored as a strategy for reducing PE and for promoting a healthier pregnancy.
Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia
The Journal of Clinical Endocrinology & Metabolism, 2007
Context: Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of preeclampsia, yet the vitamin D-preeclampsia relation has not been studied. Objectives: We aimed to assess the effect of maternal 25-hydroxyvitamin D [25(OH)D] concentration on the risk of preeclampsia and to assess the vitamin D status of newborns of preeclamptic mothers. Design and Setting: We conducted a nested case-control study of pregnant women followed from less than 16 wk gestation to delivery (1997-2001) at prenatal clinics and private practices. Patients: Patients included nulliparous pregnant women with singleton pregnancies who developed preeclampsia (n ϭ 55) or did not develop preeclampsia (n ϭ 219). Women's banked sera were newly measured for 25(OH)D. Main Outcome Measure: The main outcome measure was preeclampsia (new-onset gestational hypertension and proteinuria for the first time after 20 wk gestation). Our hypotheses were formulated before data collection. Results: Adjusted serum 25(OH)D concentrations in early pregnancy were lower in women who subsequently developed preeclampsia compared with controls [geometric mean, 45.4 nmol/ liter, and 95% confidence interval (CI), 38.6-53.4 nmol/liter, vs. 53.1 and 47.1-59.9 nmol/liter; P Ͻ 0.01]. There was a monotonic dose-response relation between serum 25(OH)D concentrations at less than 22 wk and risk of preeclampsia. After confounder adjustment, a 50-nmol/liter decline in 25(OH)D concentration doubled the risk of preeclampsia (adjusted odds ratio, 2.4; 95% CI, 1.1-5.4). Newborns of preeclamptic mothers were twice as likely as control newborns to have 25(OH)D less than 37.5 nmol/liter (adjusted odds ratio, 2.2; 95% CI, 1.2-4.1). Conclusions: Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.
Association of vitamin D deficiency during pregnancy with preeclampsia and eclampsia
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Vitamin D was considered important for bone and calcium. Historically thought to be important for bone and calcium metabolism but recent studies have redefined its role. There is some evidence now that low levels of Vitamin D are associated with the risk of preeclampsia but more studies are needed to prove the same. This study was done to determine whether vitamin D deficiency is an independent risk factor for preeclampsia/eclampsia. Methods: In this prospective case control study vitamin D levels were estimated in 92 women divided into two groups. Group 1(n = 42) included pregnant women with preeclampsia/eclampsia and group 2(n = 50) included uncomplicated pregnant women admitted in labour ward for delivery. The frequency of risk factors for preeclampsia/eclampsia were compared in two groups. Statistical analysis was done using the multivariate logistic regression analysis. Results: Almost 100% women in both groups had low vitamin D levels. Mean serum 25(OH)D levels were significantly less in Group 1(6.7236ng/ml) as compared to group 2(9.8862 ng/ml, p = 0.004). 83.3% of women in group 1 had severe deficiency (25(OH)D levels <10 ng/ml) compared to 68% women in group 2. All women (100%) in group 1 had vitamin D deficiency (<20 ng/ml) as compared to 92% in group 2 but this was not statistically significant. Conclusions: Although mean serum 25(OH)D levels were significantly less in preeclampsia/eclampsia group, prevelance of vitamin D deficiency was not significantly different in pregnant women with preeclampsia/eclampsia as compared to women who did not have preeclampsia/eclampsia.
Early pregnancy vitamin D status and risk of preeclampsia
The Journal of clinical investigation, 2016
Low vitamin D status in pregnancy was proposed as a risk factor of preeclampsia. We assessed the effect of vitamin D supplementation (4,400 vs. 400 IU/day), initiated early in pregnancy (10-18 weeks), on the development of preeclampsia. The effects of serum vitamin D (25-hydroxyvitamin D [25OHD]) levels on preeclampsia incidence at trial entry and in the third trimester (32-38 weeks) were studied. We also conducted a nested case-control study of 157 women to investigate peripheral blood vitamin D-associated gene expression profiles at 10 to 18 weeks in 47 participants who developed preeclampsia. Of 881 women randomized, outcome data were available for 816, with 67 (8.2%) developing preeclampsia. There was no significant difference between treatment (N = 408) or control (N = 408) groups in the incidence of preeclampsia (8.08% vs. 8.33%, respectively; relative risk: 0.97; 95% CI, 0.61-1.53). However, in a cohort analysis and after adjustment for confounders, a significant effect of su...
Ratio between Low Serum Maternal 25-Hydroxy vitamin D Concentration and the Risk of Preeclampsia
The Egyptian Journal of Hospital Medicine, 2018
Background: Vitamin D may play a role in the etiology of preeclampsia by regulating the transcription and function of genes associated with placental function, including placental invasion, normal implantation, and angiogenesis. Vitamin D also, modulates immune function and inflammatory response. Maternal vitamin D concentration may be influenced by several factors, including diet, supplementation, sun exposure, skin pigmentation, and genetics. Therefore, vitamin D deficiency is a potentially modifiable risk factor for preeclampsia. Objective: To find out if lower levels of vitamin D is more prevalent in preeclamptic women. Patients and Methods: This study carried out on 50 pregnant women recruited at pre labour room. They divided into preeclamptic group and non-preeclamptic group, 25 cases in each group. Current study was conducted as a case-control study to compare vitamin D level between preeclamptic and non-preeclamptic women at Al-Hussein University Hospital as current study re...
Women's Health Bulletin, 2016
Background: There is biologic and clinical evidence that links vitamin D deficiency to pre-eclampsia. The Vitamin D receptor is present in the placenta, cardiovascular system, and lymphocytes. It has anti-inflammatory, immune regulatory, and antihypertensive properties and facilitates placental implantation. Each of these processes is involved in the pathogenesis of preeclampsia. Objectives: The main purpose of this study was to study the relationship between vitamin D deficiency and severe pre-eclampsia in a population residing in southern Iran that is generally known to have a high prevalence of vitamin deficiency. As a second objective, the prevalence of vitamin D deficiency in pregnant women was investigated. Patients and Methods: We conducted a case-control study of 59 patients with severe preeclampsia and 217 controls, all of whom were from southern Iran. Cases and controls were matched for age, body mass index, and gestational age. The study was carried out in autumn and winter. Plasma 25-hydroxyvitamin D was measured using high performance liquid chromatography, and the results were compared between the two groups. Results: Almost all controls and patients had 25-hydroxyvitamin D levels below normal, and 69% had levels below 10 ng/mL. The mean 25-hydroxyvitamin D levels in the patient and control groups were 8.4 (6.2) and 8.5 (6.9) ng/ml (P = 0.80), respectively. The level of 25-hydroxyvitamin D had no significant association with subjects' body mass index or age. Conclusions: Pregnant women in our region have a high prevalence of vitamin D deficiency, and in a population with severe vitamin D deficiency, there is no significant correlation between 25-hydroxyvitamin D levels and preeclampsia. Severe deficiency masks any possible association in a case-control study. Controlled trials with vitamin D supplementation are recommended for further studies.
Association of Low Vitamin D with Pre Eclampsia
International Journal of Medical Science And Diagnosis Research
Objective: To determine the association of preeclampsia and vitamin D deficiency. Study design: Cohort study. Place and duration of study: Gynecology Department, Khwaja Muhammad Safdar Medical College, during 01-07-2018 to 31-12-2018. Material and Methods: In this study the pregnant females irrespective of their gravida and parity status and having gestational age more than 20 weeks were included. The cases that had vitamin D level lower were labelled as cases and those with normal levels as controls. They these cases were followed monthly until delivery and during this period they were followed for protein urea and BP to label pre eclampsia. Results: In this study 100 cases were selected. 50 in each group. Mean age in case and control group was 29.57±4.57 vs 28.43±3.79 years and mean duration of gestation at presentation was 26.43±5.11 vs 27.42±5.23 weeks. There were 39 vs 41 multigravida and 37 vs 38 uneducated females in cases and control group respectively. Preeclampsia was seen...
Nutrients
Preeclampsia is a pregnancy-specific illness that is hypothesized to occur due to vitamin D deficiency during pregnancy. Therefore, vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being. The present study follows a case-control analysis that aims to determine the effect of vitamin D supplements on reducing the probability of recurrent preeclampsia. We identified 59 patients for the control group without vitamin D supplementation during pregnancy, while 139 patients were included in the cases group of pregnant women with a history of preeclampsia who confirmed taking daily vitamin D supplements in either 2000 UI or 4000 UI until the 36th week of pregnancy. There were 61 (80.3%) patients with a normal serum vitamin D level measured at 32 weeks in the pregnant women who took a daily dose of 4000 UI vitamin D and 43 (68.3%) in those who took a 2000 UI dose of vitamin D, compared to just 32 (54.2%) in those who did n...
Vitamin D in Prevention of Preeclampsia
Journal of medical science and clinical research, 2019
The present study aimed to analyse the relation between vitamin D and preeclampsia. 120 pregnant females with a single ton pregnancy (healthy/preeclamptic) were selected and their body mass index was determined. They were further divided into four groups; normotensive patients with body mass index<25 kg/m2 (Group-I, N=30'CONTROL'), normotensive patients with body mass index>25 kg/m2 (Group-II, N=30), preeclamptic patients with body mass index<25 kg/m2 (Group-III, N=30), and preeclamptic patients with body mass index>25 kg/m2 (Group-IV, N=30). Their serum 25 OH D levels were analysed. Through the analysis, preeclamptic patients showed significantly reduced serum levels of vitamin D and a positive association between low vitamin D levels and preeclampsia was observed.
International Journal of Research in Pharmaceutical Sciences, 2020
The beneficial effects of sunlight in preventing bone-related disorders have been well-known for centuries. Vitamin D is a modified steroid, synthesised under the influence of sunlight in the skin. Low Vitamin D status has associated with a higher risk of pre-eclampsia in pregnant womens. The aim of this study was to undertake a systematic review of different studies investigating the association between Vitamin D levels and pre-eclampsia in pregnant womens. A systematic review was undertaken. MEDLINE, PUBMED, EMBASE, Google Scholar were searched. The review protocol was designed to answer the question. Search terms (Preeclampsia and Vitamin D or 1,25 dihydroxy vitamin D). The search was confined to peer-reviewed articles that were published in English and contained an abstract. Reference list of journal articles were also screened for additional citations fitting our search criteria. Twenty-Seven studies were included in the systematic review that investigates the association betwe...